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NPI Code Detail

MEDICARE: DR. SCHUYLER ANNE VANDYKE D.M.D.

MEDICARE: DR. SCHUYLER ANNE VANDYKE D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry1880MT
21223X2210XOrofacial Pain Dentistry1880MT
3332BC3200XCustomized Equipment (DME)1880MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25512182OTHERMTMONTANA CHIPS PROGRAM
31880OTHERMTBLX OF MONTANA

General Provider Information

NPI Number : 1689890899
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCHUYLER ANNE VANDYKE D.M.D.
Provider Business Mailing Address
First Line : 114 13TH ST S
Second Line :
City : GREAT FALLS
State : MT
Zip : 59401-3816
Country : US
Telephone Number : 406-952-0154
Fax Number : 406-952-0153
Provider Business Practice Location Address
First Line : 114 13TH ST S
Second Line :
City : GREAT FALLS
State : MT
Zip : 59401-3816
Country : US
Telephone Number : 406-952-0154
Fax Number : 406-952-0153
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2007
Last Update Date : 05/19/2022

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